Individual
DR. JASON HALEGOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, MD, MBA
Contact information
Practice address
207 HALLOCK RD STE 106, STONY BROOK, NY 11790-3075
(631) 675-9777
(631) 675-9778
Mailing address
11 LILY DR, SOUTH SETAUKET, NY 11720-2001
(516) 650-3636
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
231789
NY
Other
Enumeration date
08/21/2006
Last updated
03/12/2024
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